Slow Down!
Arrhythmia
This Means Trouble
chest pain
Its BIG
100
sinus tachycardia
100
no p waves, QRS complexes irregularly irregular
atrial fibrillation
100
PVC - bigeminy
100
+/- fever, shortness of breath, chest pain
myocarditis
100
left ventricular hypertrophy - large R waves in V6 and deep S waves in V1
200
SVT
200
ventricular fibrillation
200
hyperkalemia
200
Wolff Parkinson White syndrome - delta waves and shortened PR interval
200
right ventricular hypertrophy- large S wave in lead 1, Larger R waves in V1 and deep S waves in V6
300
Ventricular tachycardia
300
atrial flutter
300
prolonged QT - long QT syndrome, hypocalcemia
300
pain worsens with deep breath or laying flat, improves with leaning forward; friction rub on exam
pericarditis
300
left atrial enlargement- notch in p wave "p-mitrale"
400
Sick sinus syndrome - SA node doesn't fire properly causing tachycardia or bradycardia
400
Torsades de pointes
400
second degree heart block - mobitz type 2, can lead to sudden cardiac death
400
pericardial effusion - electrical alternans (every other QRS has varying amplitude) or low voltage QRS
400
right atrial enlargement - peaked P waves
500
junctional tachycardia (accelerated junctional rhythm) - narrow QRS, no P waves; a form of SVT characterized by involvement of AV node with generation of impulses from a focus in the region of AV node due to an AV disassociation
500
Brugada syndrome - elevated ST and inverted Twave in V1-V3; sodium channelopathy
500
3rd degree heart block
500
pulmonary embolus - S1Q3T3 sign (prominent S wave in lead1, Q wave and inverted T wave in lead3); reflects acute pressure and volume overload of right ventricle because of pulmonary hypertension; present in 15-25% of PE
500
hypertrophic cardiomyopathy - LVH (deep S wave V1 and large R wave V6), tall R waves in septal leads and deep S waves in lateral leads